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Should I have a yellow fever innoculation
Mar 28, 2006

I am traveling to Kenya on holiday in late June/July. The visa for Kenya seems to indicate that a yellow fever innoculation is required. My CD4 as of yesterday was 450 with an undetectable viral load. I had PCP two years ago for which I take Dapsone. Last year I had Videx related pancreatitis, which reversed with a change in medications. My liver tests with ferritin at 600, but is otherwise normal; the doctors suspect I may have hereditary hemochromotosis. My thyroid functions are low.

Response from Dr. Henry

Good question. Persons who remain immunocompromised due to HIV should not receive yellow fever vaccination since it is a live virus. If a person is asymptomatic with a good CD4 count then yellow fever vaccination is generally OK if potential exposure to yellow fever can not be avoided. Your case in in the gray zone since you had severe immune compromise and have subsequently recovered so it is hard to make a firm recommendation. If your route in Kenya includes clear risk for mosquito exposures then many would opt for vaccination. A waiver can be requested if otherwise the decision is made not to vaccinate. There are cases reported in the literature of vaccination without apparent problems. A case of fatal encephalitis has been reported after vaccination in a patient with severe HIV related immune compromise that was not recognized prior to the vacccination. KH



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